I will be the first to admit that I am not a “policy wonk” on Obamacare. While I have a decent working knowledge, I certainly am NOT an expert. But here is what baffles me ...
While I am all about not wanting Obamacare in one’s State, by “turning it down”, all that does is permit the Feds to set it up in your State and run it. So the result of doing this is to essentially hand the Feds the ability to set up a very real form of universal HealthCare and run the thing.
I get the knee-jerk reaction to doing this, but following the SCOTUS decision I am not sold on it’s ultimate wisdom. You actually invite the Feds to do MORE? I just don’t get why.
Not sure of the details, but it's the same here in Indiana. We have elected not to move forward and fund a state exchange, and we have chosen not to expand Medicaid.
Although it sounds worse, the general thinking is that there is NO federal system to implement. No one has any clue what the requirements are, and how such a system would work. It's "un-implementable" as it currently stands.
Our outgoing Governor Daniels, as well as incoming Governor Pence, have both chosen NOT to
invest waste state dollars in an unworkable system. (And I mean that both from an organizational and technical standpoint.)
My understanding it is a budgetary decision
ObamaCare Mandates increasing the Medicaid Income thresholds
and increases the mandated services in such a way as to, overall,
increase the States’ Medical Expenditure Costs significantly,
and to a degree not supplemented by Federal Grants,
making it a net money loser for states due to cost shifting.
Not exactly. State refusla does allow the feds to set up an exchange for you. But, the Obamacare act was passed so frenetically that they forgot to actually fund any federal exchanges. So, functionally, it may end up scuttling the whole thing.